Add eSign Patient Intake Form with airSlate SignNow

E signature patient intake form

today I'll be walking you through how DocuSign is helping many health care companies drive their digital transformation by utilizing electronic signatures this will be followed with a short product demonstration showing what it would be like to utilize DocuSign today this is the next major shift we are seen in healthcare similar to the shift from mail to fax or the more recent transition to electronic health records like the previous major transformations this is helping to improve the health of the population enhance the experience and outcomes of the patient and reduce per capita cost of care or the benefit of the community with DocuSign there are three main scenarios that our current customers are utilizing today the first scenario is a patient finds your website and fills out forms proactively in a self-service format via DocuSign power forms the second scenario as a patient doesn't have email or you're face to face with them in this situation we utilize in-person signing this will allow you to hand over a tablet for them to fill out the forms the third is emailing the patient the forms as a secure link be a standard DocuSign today I'll be playing the part of Steven cook a DocuSign user who's in charge of managing patient information a new patient named pam has just called their office and we have just scheduled her for an appointment now we can send out the patient intake forms beforehand so that she doesn't have to come in early in order to fill them out to do so I simply click new use the template here I select the template which consists of the documents that need to be filled out this would consist of your company documents for this scenario Steven has already gone through the onboarding process part of which consisted of taking his company documents and creating a template this was done with the help of our onboarding team guiding him and answering any questions along the way from here I just need to type in Pam's name and email followed by clicking on the Sun button once son we can already see that Pam has immediately received an email with a secure link in order to access these documents and begin filling them out I will also have visibility into all the documents that have been sent out but not yet been completed this will be organized in the waiting for others tab for quick access as I click into this tab I can drill down further into what documents are currently out and who they're waiting on here we can see that Pam Kevin and Marion haven't finished their intake forms yet as I click into Pam's envelope we can drill down even further to see that she hasn't opened the documents yet now when I checked Kevin's we can see that he's actually viewed the documents which probably means he started to fill out some information on the right we can see that he's taken a picture of his insurance card already and uploaded it we can also click into more form data and see an organized list of all the information gathered including a phone number to reach him now when I check into Marion's progress I notice that it's been a few days and he still hasn't view the documents yet I'll go ahead and click on the reset button to push out a new email to the top of his inbox as a reminder we're still waiting for the documents now I'm gonna switch roles and play the part of Pam who's a signer with no DocuSign account but has just received the email and is ready to start filling out our intake information you can note that there are no attachments and this is in order to satisfy HIPPA requirements there's just a secure link that when clicked on and brought into DocuSign secure servers which is encrypted every step of the way from here the patient is brought through a very guided process of what we want them to do and we're on the document as I click the navigation bar I'm brought to a text box asking for a phone number to be entered this is a DocuSign field which can include radio buttons drop-down menus and many more once we get to the Social Security number note the DocuSign is saying in proper format this is called validation in this instance I'll leave this in the incorrect format so that I can show you later what happens when I try to finish the document here we have a drop-down menu asking for marital status where when married is selected a text box appears asking for more information when single is selected the Box disappears letting them know that information isn't needed this is called conditional logic which helps to guide the user to know exactly what information we need depending on answers as Pam continues to fill out the information we come to a radio button asking if she's insured if she is not insured she knows to do nothing here and continue on with the process but if she is insured you can see we've included other text boxes to include information along with an attachment tag asking for them to take a picture of their insurance card from their phone or upload it from their drive here we get to the signature which one selected DocuSign is recognizing i'm on a laptop and asking if i'd like to select a signature style if i were on a mobile device it would have prompted the option to draw my signature with my finger this is completely up to the user and is only necessary if you don't already have a DocuSign account you can also note that we've already entered the date of birth earlier on in this document this entry has automatically been populated down to the financial responsibilities agreement once signed you can see that I have automatically been navigated back to the social security number which pam it entered in the incorrect format this helps to make sure that you are collecting all the necessary information but it also helps the guide the user where they need to make the correction now the navigation bar has disappeared and I can click finish to complete the document at this point both Pam and Stephen are automatically sent an email with a link to the completed documents within DocuSign from here our switch rolls back to Stephen who is able to access the completed documents from his email or DocuSign account from the completed folder once in the completed folder I can select the patients documents then navigate to the download icon for a copy of the completed documents we place a tamper-evident CL on all DocuSign documents so that once downloaded from DocuSign servers will still be able to tell if any modifications to the documents have been made we can also see an organized list of all the information collected which can be exported as a CSV file for easy uploading into other systems with DocuSign you not only will be able to send out intake forms as a secure link in an email but also allow patients to go through the same process in a self-service fashion from your website this is possible with what we call DocuSign power forms power forms allow you to transform any documents on your website available for download today into documents that can be filled out and completed directly from your website once completed from the site Stephen would receive an email notifying him with a link to the document for anyone who doesn't have an email or are currently face to face with the signer we do have in person signing as well this allows Stephen to start the signing process and hand over a tablet for the signer to go through the same process starting from when they see the document this will allow for a transition from documents being signed in the waiting room to three different options for signers to fill out patient forms self-service from a website or portal via email from a link that is sent or in person when the patient does not have an email